Injury In School-aged Children Research Articles

Visual field evaluation following brain injury in school-aged children

Visual field evaluation following brain injury in school-aged children

Visual evoked potential evaluation following brain injury in school-aged children.

Aim: The research aimed to establish reference values of visual evoked potentials among school-aged children after brain injury. Methods: Eighteen patients with persisting visual symptoms after brain injury have been examined. A pattern-VEP test has been used during the examination. Results: The prolongation of the N2 wave in 55,6%-66,6%, P wave in 55,7%-66,7%, and N3 wave in 16,7%-22,2% was determined in the research group. Likewise, the decrease in the amplitude of the P wave was determined in the case of 16,7%-33,3%. According to the topography, we concluded that the prechiasmatic alteration was predominantly determined as bilateral in the optic pathways, with emphasis equally on the right and left. Conclusions: VEP evaluation remains one of the most credible methods of examination. In the case of moderate or severe traumatic optic neuropathy, it allows the detection of damage to the optic pathways before the appearance of organic changes that are often irreversible. The possibility of early detection of such modifications could justify the initiation of a dosed stimulatory treatment, to avoid damage to the optic pathways that would induce secondary optic atrophy. Abbreviations: VEP = visual evoked potentials, MRI = magnetic resonance imaging.

Quantifying Pediatric Gun Violence by Location, Time of Day, and Day of Week

BackgroundFirearm injuries are the leading cause of pediatric deaths. The objective of this study was to describe the location and timing of pediatric firearm injuries and to determine the proportion of these injuries that occur within schools in the United States. MethodsIn this retrospective cohort study, we used national emergency medical services (EMS) data from 2019 to evaluate dispatches to firearm injuries involving school-aged children (age 5–18). We extracted incident location type, patient demographics, number of patients on scene, and injury intent. ResultsWe identified 4764 EMS dispatches for firearm injuries in school-aged children during 2019. Assault was the most common cause of injury (53.9 %), followed by unintentional shootings (12.1 %) and self-inflicted injuries (6.1 %). Most incidents involved a single patient (91.4 %). Private residence (51.5 %) was the most common location, followed by street/road (23.8 %). 81 firearm injuries (1.7 %) occurred in a school. Private residence was the most common location of injury across all injury intents. During school hours, most firearm injuries occurred in a private residence (51.6 %) or on a street/road (19.9 %). A total of 63 dispatches (1.3 %) were considered a mass casualty incident, of which 9 (14 %) occurred in a school. ConclusionsRegardless of injury intent or time of day, the most common location for pediatric firearm injuries was a private home. Firearm injuries within schools were far less frequent. In designing prevention strategies, our data calls for renewed focus on preventing children from accessing firearms in the home and instituting comprehensive, community-based after school programs. Type of StudyRetrospective cohort. Level of EvidenceIII.

Visual acuity disturbances following brain injury in school-aged children

Background: Visual disturbances may result in a long-term complication after mild traumatic brain injury (mTBI) in children. These problems may affect both near work and reading, and thus affect activities of daily life and the child’s return to school activity. The purpose of the study was to assess the visual acuity disturbances and refractive status in children with persisting symptoms after mild traumatic brain injury. Material and methods: Forty-eight patients with persisting symptoms after mild traumatic brain injury and anomalies of visual acuity were included. Visual symptoms and refractive status were assessed during the eye examination. Results: Thus, in the mTBI group the visual acuity for the right eye was of 0.09-0.5 in 83.7% (40 patients), in 16.3% (8 patients) – right eye 0.6-0.8, comparing to the control group, where 62% patients had the visual acuity ranged almost in 1.0, just 14% (7 patients) ranged 0.09-0.5 and in 24% (12 patients) – 0.6-0.8. The visual acuity for the left eye in the research group was of 0.09-0.5 in 89.8% (43 patients), in 10.2% (5 patients) – for the left eye was 0.6-0.8, comparing to the control group, where 66% patients had the visual acuity ranged almost in 1.0, just 24% (12 patients) it ranged 0.09-0.5 and in 14% (5 patients) – 0.6-0.8. Conclusions: Visual acuity (VA) is affected primary after head trauma although it has big chances to get better with a vision therapy in a time period ranged between 3 and 6 months after the trauma. In most of the cases, we speak of a blurred vison in the near work and relative unclear perception at far. Autorefraction data usually will reveal a slight hyperopia with a possible astigmatic component ranged between 1D to 3D, and in 4.1%-8.2% of cases a slight myopia referring to the spherical compound and 18.4%-32.7% astigmatic compound, also ranged between 1D and 3D.

Risk Factors of Sports-Related Injury in School-Aged Children and Adolescents: A Retrospective Questionnaire Survey.

Studies conducting quantitative surveys in school-aged children and adolescents help identify sports-related risk factors for acute and overuse injuries are scarce. This study aimed to quantify the risk factors for sports-related injury in school-aged children and adolescents by school categories. University students (n = 484) retrospectively recalled their sports experiences and related injuries in a questionnaire according to the following school categories: lower elementary school (LE), upper elementary school (UE), junior high school (JH), and high school (H). Both sports-related acute and overuse injuries were recorded. After adjusting various covariates, weekly hours in sports were identified as a significant risk factor in LE and UE. The interaction of weekly hours in sports and sports specialization was significant in LE and UE, suggesting that early specialization would be a risk factor in lower school categories. In JH and H, female sex, high-level competition, and injury experienced in a previous school category were significantly related to sports-related injuries. In conclusion, weekly hours in sports, high-level competitions, previous injury experience, and sex were confirmed as risk factors in specific school categories. Most identified risk factors are modifiable, suggesting that sports-related injuries can be prevented in school-aged children and adolescents.

Trends in Traumatic Brain Injury Related to Consumer Products Among U.S. School-aged Children Between 2000 and 2019

Consumer product‒related traumatic brain injury in children is common, but long-term trends have not been well characterized. Understanding the long-term trends in consumer product‒related traumatic brain injury may inform prevention efforts. The study objective is to examine the trends in consumer product‒related traumatic brain injury in school-aged children. Data were extracted from the National Electronic Injury Surveillance System-All Injury Program for initial emergency department visits for consumer product‒related traumatic brain injury (2000-2019) in school-aged children and analyzed in 2021. Approximately 6.2 million children presented to emergency department with consumer product‒related traumatic brain injury during 2000-2019. Consumer product‒related traumatic brain injury increased from 4.5% of overall consumer product‒emergency department visits in 2000 to 12.3% in 2019, and its incidence rate (cases per 100,000 population) was higher in males (681.2; 95% CI=611.2, 751.2) than in females (375.8; 95% CI=324.1, 427.6). The annual percentage change in consumer product‒related traumatic brain injury was 3.6% from 2000 to 2008, 13.3% from 2008 to 2012, and ‒2.0% through 2019. Average annual percentage change was higher in females (5.1%; 95% CI=3.4, 6.8) than in males (2.8%; 95% CI=1.6, 3.9). Consumer product‒related traumatic brain injury increased from 2000 to 2012 in females and then remained stable. In males, annual percentage change increased from 2008 to 2012 and then declined through 2019. Traumatic brain injury incidence rate in school-aged children increased from 2000 to 2019, peaked in 2012, and then declined in males but not in females. Percentage increases were highest in females. Prevention strategies should continue, with a specific focus on reducing consumer product‒related traumatic brain injury in female children.

Preventing Unintentional Injuries in School-Aged Children: A Systematic Review.

Unintentional injuries constitute the leading causes of death and long-term disabilities among children aged 5 to 15 years. We aimed to systematically review published literature on interventions designed to prevent unintentional injuries among school-aged children. We searched MEDLINE, PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO and screened the reference lists of included studies and relevant reviews. We included randomized controlled trials, controlled before-and-after studies, and interrupted time series studies. The focus of included studies was on primary prevention measures. Two reviewers collected data on type of study design, setting, population, intervention, types of injuries, outcomes assessed, and statistical results. Of 30 179 identified studies, 117 were included in this review. Most of these studies were conducted in high-income countries and addressed traffic-related injuries. Evidence from included studies reveals that multicomponent educational interventions may be effective in improving safety knowledge, attitudes, and behaviors in school-aged children mainly when coupled with other approaches. Laws/legislation were shown to be effective in increasing cycle helmet use and reducing traffic-related injury rates. Findings reveal the relevance of infrastructure modification in reducing falls and improving pedestrian safety among children. Additional studies are needed to evaluate the impact of unintentional injury prevention interventions on injury, hospitalizations, and mortality rates and the impact of laws and legislation and infrastructure modification on preventing unintentional injuries among school-aged children.

Item Pool Development for the School-Aged Life Impact Burn Recovery Evaluation Profile Computerized Adaptive Test: An Observer-Reported Outcome Assessment Measuring the Impact of Burn Injuries in School-Aged Children.

The transition from early childhood to teen years (5-12) is a critical time of development, which can be made particularly challenging by a burn injury. Assessing postburn recovery during these years is important for improving pediatric survivors' development and health outcomes. Few validated burn-specific measures exist for this age group. The purpose of this study was to generate item pools that will be used to create a future computerized adaptive test (CAT) assessing postburn recovery in school-aged children. Item pool development was guided by the previously developed School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE5-12) conceptual framework. The item pool development process involved a systematic literature review, extraction of candidate items from existing legacy measures, iterative item review during expert consensus meetings, and parent cognitive interviews. The iterative item review with experts consisted of six rounds. A total of 10 parent cognitive interviews were conducted. The three broad themes of concern were items that needed 1) clarification, needed context, or were vague, 2) age dependence and relevance, and 3) word choice. The cognitive interviews indicated that survey instructions, recall period, item stem, and response choices were interpretable by respondents. Final item pool based on parental feedback consists of 57, 81, and 60 items in physical, psychological, and family and social functioning, respectively. Developed item pools (n = 198) in three domains are consistent with the existing conceptual framework. The next step involves field testing the item pool and calibration using item response theory to develop and validate the SA-LIBRE5-12 CAT Profile.

Effect of parental education and household poverty on recovery after traumatic brain injury in school-aged children

ABSTRACT Objective While prior studies have found parental socioeconomic status (SES) affects the outcomes of pediatric traumatic brain injury (TBI), the longitudinal trajectory of this effect is not well understood. Methods This prospective cohort study included children 8–18 years of age admitted to six sites with a complicated mild (n = 123) or moderate-severe TBI (n = 47). We used caregiver education and household poverty level as predictors, and multiple quality of life and health behavior domains as outcomes. Differences at 6, 12, and 24 months from baseline ratings of pre-injury functioning were compared by SES. We examined the association between measures of SES and domains of functioning over the 24 months post-injury in children with a complicated mild or moderate- severe TBI, and determined how this association varied over time. Results Parental education was associated with recovery among children with complicated mild TBI; outcomes at 6, 12, and 24 months were substantially poorer than at baseline for children with the least educated parents. After moderate-severe TBI, children in households with lower incomes had poorer outcomes compared to baseline across time. Implications Parental education and household income were associated with recovery trajectories for children with TBI of varying severity.

An investigation of extremity injuries in school-aged children presenting to the emergency department

An investigation of extremity injuries in school-aged children presenting to the emergency department

School Nurses: An Indispensable Resource for Health Promotion in Ontario's Children and Adolescents

School nurses play an important role in the promotion of physical, mental, and social health, as well as the prevention of disease and injury in school-aged children. Promotion of health is also a central goal of the Ontario government, and is codified in the Health Protection and Promotion Act (HPPA). Part I of this paper demonstrates that a reasonable interpretation of the HPPA supports the implementation of a robust school nurse program that can meet the health needs of children. Part II explores the shortcomings of current school health programs in Ontario and provides policy reasons that support a comprehensive school nurse program. Part III identifies logistical barriers to the implementation of a school nurse program that need to be overcome in order to plan and provide adequate school nurse programs. A significant increase in the availability of school nurses is an optimal way to fulfill the Ontario government’s legislative objectives of protecting and promoting public health in its communities. The scope of practice of registered nurses places them in the best position to implement and ensure that the goals of the HPPA are met in Ontario’s schools.

Penerapan Symbolic Modeling melalui Pendekatan Asuhan Keperawatan Keluarga dalam Menurunkan Kejadian Cedera pada Anak Usia Sekolah

Abstrak
 
 Cedera menjadi ancaman kesehatan dunia karena 7% kematian diakibatkan oleh cedera. Hasil riset kesehatan dasar (2013) menunjukkan bahwa kejadian cedera yang terjadi di rumah sebanyak 36,5%. Faktor perilaku yang meliputi pengetahuan, sikap dan keterampilan keluarga terkait pencegahan cedera berpengaruh terhadap kejadian cedera pada anak usia sekolah. Strategi pencegahan cedera yang dilakukan adalah dengan Model Simbol menggunakan video animasi melibatkan keluarga. Penelitian ini bertujuan untuk memberikan gambaran penerapan Model Sandi (Simbol Andi) dalam pencegahan cedera pada keluarga. Desain penelitian ini adalah studi kasus. Jumlah sampel penelitian sebanyak 10 keluarga yang diambil melalui tehnik purposive sampling. Penelitian ini dilakukan selama 6 bulan. Hasil penelitian menunjukkan adanya perubahan pengetahuan, sikap dan keterampilan keluarga serta terjadi peningkatan tingkat kemandirian keluarga. Intervensi Model Sandi diharapkan dapat dijadikan salah satu pendekatan intervensi keperawatan keluarga dalam menyelesaikan permasalahan risiko cedera pada anak usia sekolah.

Higher Brain Dysfunction after Traumatic Brain Injury in School-aged Children: Review of the Literature

Higher Brain Dysfunction after Traumatic Brain Injury in School-aged Children: Review of the Literature

Poster 128: Unmet Rehabilitation Needs After Traumatic Brain Injury in School-Aged Children

Poster 128: Unmet Rehabilitation Needs After Traumatic Brain Injury in School-Aged Children

Increased Risk of Subclinical Hepatic Injury in Children Exposed to Thiodiglycolic Acid

Background. Previous study have revealed a higher exposure level of urinary thiodiglycolic acid (TDGA), a major metabolite of vinyl chloride monomer (VCM), in school-aged children near a petrochemical complex. However, few study assess the risk of hepatic injury of children exposed to VCM. We aim to assess the risk of hepatic injury in school-aged children using urinary TDGA. Methods. We included 316 children (aged 7-13 years old) who provided blood and urine samples from an established cohort in 2013. First morning urine and blood samples were obtained from each subject on Wednesday from October 2013 to September 2014. Urinary TDGA was analyzed by LC/MS-MS. Serum sample was analysis for hepatic injury index including aspartate aminotransferase (AST), AST to platelet ratio index (APRI) and fibrosis-4 score (FIB-4). Results. We found that children with the highest quartile (Q4, >161 μg/g creatinine) of urinary TDGA level had significant higher AST levels than that in the lowest quartiles (Q1, <36 μg/g creatinine) (p= 0.03). We found that our subject with Q4 of urinary TDGA level significantly had a 2.49 fold risk of subclinical AST abnormal than that with Q1 (OR = 2.49; 95% CI: 1.06 ~ 5.83, p = 0.036) after adjustment for age, sex, BMI, physical activity, etc. Conclusions. We concluded that higher TDGA exposure in school-aged children near a petrochemical complex was significantly associated with increased risk of subclinical AST abnormal after adjustment for significant covariance.

The incidence of idiopathic musculoskeletal pain in children with upper extremity injuries

IntroductionChildren with upper extremity injuries may report persistent pain beyond the period of acute injury. In the published literature, it is unclear whether these children develop idiopathic musculoskeletal pain (IMP) such as complex regional pain syndrome (CRPS). The purpose of this study was to determine the incidence rate of IMP after upper extremity injury in school-aged children over a 5-year period and to describe the characteristics of these children. MethodsA retrospective case series was conducted of all children aged 8–18 years with an upper extremity injury who attended the outpatient hand clinic in a tertiary care pediatric hospital. ResultsA reported incidence rate of IMP was 1.9% over a 5-year period in the 879 children reviewed. Girls were more likely to have IMP. The categorical distribution of the type, etiology and anatomical location of injury was proportionately different for those with IMP compared to those without documentation of IMP. In comparison, a higher percentage of children with IMP reported disproportionate pain and hypersensitivity or neuropathic pain symptoms compared to the children who had pain from a known etiology. ConclusionThe incidence rate of IMP after upper extremity injury in school-aged children is low. Some common characteristics of this population that may help clinicians identify these children and make timely referrals for treatment include female gender, disproportionate pain, previously seen by multiple specialists, generalized injury in the hand, unspecific etiology or type of injury and unremarkable x-rays.

Effectiveness of a Safe Routes to School Program in Preventing School-Aged Pedestrian Injury

In 2005, the US Congress allocated $612 million for a national Safe Routes to School (SRTS) program to encourage walking and bicycling to schools. We analyzed motor vehicle crash data to assess the effectiveness of SRTS interventions in reducing school-aged pedestrian injury in New York City. Using geocoded motor vehicle crash data for 168 806 pedestrian injuries in New York City between 2001 and 2010, annual pedestrian injury rates per 10 000 population were calculated for different age groups and for census tracts with and without SRTS interventions during school-travel hours (defined as 7 am to 9 am and 2 pm to 4 pm, Monday through Friday during September through June). During the study period, the annual rate of pedestrian injury decreased 33% (95% confidence interval [CI]: 30 to 36) among school-aged children (5- to 19-year-olds) and 14% (95% CI: 12 to 16) in other age groups. The annual rate of school-aged pedestrian injury during school-travel hours decreased 44% (95% CI: 17 to 65) from 8.0 injuries per 10 000 population in the preintervention period (2001-2008) to 4.4 injuries per 10 000 population in the postintervention period (2009-2010) in census tracts with SRTS interventions. The rate remained virtually unchanged in census tracts without SRTS interventions (0% [95% CI: -8 to 8]). Implementation of the SRTS program in New York City has contributed to a marked reduction in pedestrian injury in school-aged children.

Schools as TBI Service Providers

Schools as TBI Service Providers

Treatment of femur fractures in school-aged children using elastic stable intramedullary nailing

Femur fractures are common long-bone injuries in school-aged children (6-12 years). Among the various acceptable treatment options, elastic stable intramedullary nailing (ESIN) has gained popularity over recent years although the level of evidence for ESIN is low. This study was a systematic review of the literature to examine the outcomes and complications of ESIN in school-aged children and to critically evaluate the quality of the available literature. Although most complications were minor, some series report complication rates of more than 50%. Union rates are high. Malunion or mechanical axis malalignment, on the other hand, is common, and leg length discrepancy and overgrowth are also not unusual. Symptomatic implants are common, particularly if the distal ends of the nail are left long and prominent. Refracture was noted to be uncommon in this population. ESIN is a well-accepted and reliable option for treatment of femur fractures in school-aged children. Advantages are decreased length of hospital stay, early return to function, and high union rates. Care must be taken to obtain and maintain reduction, and caution is advised in older and heavier children.

Orofacial and dental trauma of young children in Dunedin, New Zealand

The aims were to identify the predominant causes and types of orofacial injury in young children attending clinics at a University Dental School in Dunedin, New Zealand. A retrospective analysis of data from the records of all children aged 0-10years who had been seen for orofacial trauma in 1999 and 2000 was undertaken. Three hundred traumatic incidents in 288 children were analysed; 86.6% had causes noted. In very young children, most injuries were because of falls, while collisions, falling and sports were responsible for more injuries in school-aged children. Playground equipment and ride-on vehicles played a role particularly in the older children. There were no incidents of trauma as a result of road traffic accidents. Ten injuries were caused by animals, mainly dogs. Location was recorded for two-thirds of accidents: the predominant place was at home, followed by school. No seasonal variation was apparent. There were 228 non-dental injuries, of which the majority were to the lips. The predominant dental injuries in both dentitions were concussions and subluxations with a significantly higher occurrence of both in the primary dentition (P<0.001). Upper central incisors were most often involved. The age distribution for boys and girls was similar. In conclusion, the causes and types of orofacial trauma in this group of young New Zealand school children attending a university dental school were similar to other studies, except for the high proportion of concussions recorded in both dentitions. While the injuries were well described, not all records noted the cause or location. This has resulted in changes to the standard recording form to provide consistency in data capture. Information from this study will also be used to support child injury prevention strategies in New Zealand.